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Disc Disease (disc + disease)
Kinds of Disc Disease Selected AbstractsComplications of Methylprednisolone Sodium Succinate Therapy in Dachshunds with Surgically Treated Intervertebral Disc DiseaseJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 2 2001Amanda K. Boag MA VetMB, MRCVS; Abstract Objective: To compare the incidence of clinically evident post-operative complications, financial cost and length of hospital stay for Dachshunds with acute intervertebral disc disease treated with decompressive surgery with and without the use of methylprednisolone sodium succinate (MPSS). Design: Retrospective clinical study Setting: Veterinary Teaching Hospital Animals: Dachshunds that presented to the Veterinary Hospital of the University of Pennsylvania between January 1994 and December 1999 with acute intervertebral disc disease that were treated with decompressive surgery. Intervention: None Measurements and Main Results: Dogs were divided into 2 groups dependent upon whether they had received MPSS. Medical records were examined for evidence of post-operative complications. Other parameters recorded included details of drugs administered (principally corticosteroids and gastrointestinal protectant drugs), length and cost of hospital stay and neurological status at 24 hours post-operatively and at suture removal. Compared to other corticosteroids, dogs receiving MPSS had a significantly higher incidence of clinically evident post-operative gastrointestinal complications, an increased use of gastrointestinal protectant drugs, and an increased cost for hospital stay (p<0.01). Conclusions: The use of MPSS inDachshunds with acute intervertebral disc disease is associated with an increased post-operative complication rate and an increased financial cost to the client. The use of MPSS should be carefully evaluated for each patient. [source] Agreement Between Self-Report of Disease Diagnoses and Medical Record Validation in Disabled Older Women: Factors That Modify AgreementJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2004Crystal F. Simpson MD Objectives: To determine the agreement between self-report of chronic disease and validated evidence of disease using multiple ascertainment methods and to assess effects of cognition, education, age, and comorbidity. Design: Cross-sectional analysis. Setting: Community Baltimore, Maryland. Participants: One thousand two community-dwelling disabled women aged 65 and older. Measurements: Kappa statistics were calculated to determine the relationship between self-report of 14 diseases and standardized algorithms. Analyses were stratified using Mini-Mental State Examination score, education, number of chronic diseases, and age. Results: Kappa was excellent for hip fracture (HF), Parkinson's disease (PD), diabetes mellitus (DM), cancer, stroke, and disc disease (DD); fair to good for angina pectoris, congestive heart failure, and myocardial infarction; and poor for peripheral arterial disease, spinal stenosis, osteoporosis, arthritis, and lung disease. Overall, kappa decreased with decreasing cognition and education, increasing age, and four or more diseases. Conclusion: In disabled older women, self-report of physician diagnosis of HF, PD, DM, cancer, stroke, and DD appears valid. In general, increasing comorbidity and age and decreasing cognition and education do not reduce validity for diseases where agreement was excellent overall. [source] An in vivo model of degenerative disc diseaseJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 1 2003Jason P. Norcross Although the precise etiology of low back pain is disputed, degeneration of the intervertebral disc is believed to play an important role. Many animal models have been described which reproduce the changes found in degenerative disc disease, but none allow for efficient, large-scale testing of purported therapeutic agents. The purpose of this study was to develop a simple animal model resembling degenerative disc disease using the intervertebral discs found in the tails of rats. The proximal two intervertebral discs in the tails of 20 rats were injected with either chondroitinase ABC or control (phosphate buffered saline, PBS). The tails were harvested at 2 weeks, and measurements were made of intervertebral disc height (measured radiographically and histologically), biomechanics (stiffness, hysteresis, and residual deformation), and histologic appearance. Treatment with chondroitinase ABC resulted in a significant loss in intervertebral disc height (radiographic intervertebral disc height, p < 0.001; histologic intervertebral disc height, p < 0.001) and significant increases in all biomechanical parameters (stiffness, p < 0.001; hysteresis, p < 0.006; residual deformation, p < 0.004) compared to PBS controls. Intervertebral discs treated with chondroitinase ABC had significantly lower histologic grades for each grading category (nucleus pulposus (NP), annulus fibrosus, and proteoglycan staining) compared to controls. The results of injury with chondroitinase ABC were similar to the findings in degenerative disc disease: reduced intervertebral disc height, diminished proteoglycan content, loss of NP cells, and increased stiffness of the disc. Thus, the model appears to be a reasonable tool for the preliminary in vivo evaluation of proposed treatments for degenerative disc disease. © 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source] Association of spinal cord compression seen on magnetic resonance imaging with clinical outcome in 67 dogs with thoracolumbar intervertebral disc extrusionJOURNAL OF SMALL ANIMAL PRACTICE, Issue 11 2006V. Penning Objectives: To determine whether there is an association between the degree of transverse spinal cord compression detected by magnetic resonance imaging following thoracolumbar Hansen type 1 intervertebral disc disease in dogs and their presenting and postsurgical neurological status. Methods: Medical records of 67 dogs with surgically confirmed Hansen type 1 intervertebral disc disease (2000 to 2004) were reviewed to obtain the rate of onset of disease, duration of clinical signs and presurgical and postsurgical neurological grade. Percentage of spinal cord compression was determined on transverse T2-weighted magnetic resonance images. Linear regression was used to examine the association between spinal cord compression and each of the above variables. Chi-squared tests were used to examine associations among postsurgical outcome and presurgical variables. Results: Eighty-five per cent (57 of 67) of dogs were chondrodystrophoid. Mean spinal cord compression was 53 per cent (sd=219·7, range 14·3 to 84·9 per cent). There was no association between the degree of spinal cord compression and the neurological grade at presentation, rate of onset of disease, duration of clinical signs or postsurgical outcome, with no difference between chondrodystrophoid and non-chondrodystrophoid dogs. Clinical Significance: The degree of spinal cord compression documented with magnetic resonance imaging in dogs with thoracolumbar Hansen type 1 intervertebral disc disease was not associated with the severity of neurological signs and was not a prognostic indicator in this study. [source] Partial percutaneous discectomy for treatment of thoracolumbar disc protrusion: retrospective study of 331 dogsJOURNAL OF SMALL ANIMAL PRACTICE, Issue 10 2005S. Kinzel Objectives: To determine retrospectively the prognosis and outcome for dogs diagnosed with thoracolumbar intervertebral disc disease treated with partial percutaneous discectomy (PPD). Methods: Three hundred and thirty-one dogs presenting with symptoms of thoracolumbar intervertebral disc disease from 1998 to 2003 were treated with PPD. Diagnosis and location of intervertebral disc disease was confirmed by clinical examination, radiography, myelography and magnetic resonance imaging. PPD was performed via fluoroscopy-guided removal of a 5 mm bore cylinder out of the central intervertebral space. Results: Clinical success after surgery was achieved in 159 (88·8 per cent) grade II to IV patients and 58 (38·2 per cent) grade V patients. The mean (sd) time from percutaneous discectomy to first improvement was 8·3 (13·2) days. Clinical Significance: The PPD approach to the thoracolumbar spine involves minor trauma (yielding rapid recovery) and less pain, and produces results comparable with open fenestration. Consequently, this simple minimal invasive technique can be recommended as an alternative to the technique of fenestration and can be easily performed in addition to open surgical decompression techniques or prophylactically. However, it is not a replacement for surgical treatment in dogs with thoracolumbar disc disease that require removal of disc fragments causing spinal cord or nerve root compression. [source] Thoracolumbar disc disease in 71 paraplegic dogs: influence of rate of onset and duration of clinical signs on treatment resultsJOURNAL OF SMALL ANIMAL PRACTICE, Issue 4 2002A. J. A. Ferreira Seventy-one paraplegic dogs with confirmed intervertebral thoracolumbar disc disease and intact deep pain sensation were treated by hemilaminectomy and fenestration of at least two adjacent discs. The success rate of treatment in the overall population was 86 per cent (61/71 cases), with a mean length of time to regaining the ability to walk of 10·8 days and a mean follow-up time of 29 months. The rate of onset of clinical signs significantly influenced the clinical outcome (P=0·01) but not the length of recovery time (P=0·45). Conversely, the duration of clinical signs did not seem to significantly affect the outcome (P=0·27), but did affect the length of recovery time (P=0·001). Animals which had shown clinical signs for more than six days took significantly longer to regain the ability to walk (ie, an additional 6·9 days, P=0·04 and 4·5 days, P=0·01), when compared with those which had shown clinical signs for less than two days, or more than two but less than six days, respectively. [source] Complications of Methylprednisolone Sodium Succinate Therapy in Dachshunds with Surgically Treated Intervertebral Disc DiseaseJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 2 2001Amanda K. Boag MA VetMB, MRCVS; Abstract Objective: To compare the incidence of clinically evident post-operative complications, financial cost and length of hospital stay for Dachshunds with acute intervertebral disc disease treated with decompressive surgery with and without the use of methylprednisolone sodium succinate (MPSS). Design: Retrospective clinical study Setting: Veterinary Teaching Hospital Animals: Dachshunds that presented to the Veterinary Hospital of the University of Pennsylvania between January 1994 and December 1999 with acute intervertebral disc disease that were treated with decompressive surgery. Intervention: None Measurements and Main Results: Dogs were divided into 2 groups dependent upon whether they had received MPSS. Medical records were examined for evidence of post-operative complications. Other parameters recorded included details of drugs administered (principally corticosteroids and gastrointestinal protectant drugs), length and cost of hospital stay and neurological status at 24 hours post-operatively and at suture removal. Compared to other corticosteroids, dogs receiving MPSS had a significantly higher incidence of clinically evident post-operative gastrointestinal complications, an increased use of gastrointestinal protectant drugs, and an increased cost for hospital stay (p<0.01). Conclusions: The use of MPSS inDachshunds with acute intervertebral disc disease is associated with an increased post-operative complication rate and an increased financial cost to the client. The use of MPSS should be carefully evaluated for each patient. [source] The application of 23Na double-quantum-filter (DQF) NMR spectroscopy for the study of spinal disc degenerationMAGNETIC RESONANCE IN MEDICINE, Issue 2 2008Kristopher J. Ooms Abstract Degenerative disc disease is an irreversible process that leads to a loss of mechanical integrity and back pain in millions of people. In this report, 23Na double-quantum-filtered (DQF) NMR spectroscopy is used to study disc tissues in two stages of degeneration. Initial results indicate that the 23Na DQF signal may be useful for determining the degree of degeneration. The spectral analysis reveals the presence of sodium environments with different residual quadrupolar couplings and T2 relaxation times that we attribute to different regions, or compartments, corresponding to different biochemical regions in the tissue. In general it is found that there are compartments with no residual quadrupolar couplings, compartments with moderate couplings (200 to 1000 Hz), and compartments with couplings ranging from 1500 to 3000 Hz. The results indicate that 23Na DQF NMR spectroscopy provides a probe of the degenerative state of the intervertebral disc tissues, and might hold potential as a novel diagnostic method for detection of disc degeneration. Magn Reson Med 60:246,252, 2008. © 2008 Wiley-Liss, Inc. [source] Intervertebral Disc Biacuplasty for the Treatment of Lumbar Discogenic Pain: Results of a Six-Month Follow-UpPAIN MEDICINE, Issue 1 2008Leonardo Kapural MD ABSTRACT Objective., Intradiscal biacuplasty (IDB) is a novel bipolar cooled radiofrequency system for the treatment of degenerative disk disease. We present the results of a pilot trial with 6-month follow-up. Design, Setting, Patients, and Interventions., Fifteen patients, 22,55 years old, underwent one- or two-level IDB treatment of their painful lumbar discs. All had chronic low back pain >6 months, back pain exceeding leg pain, concordant pain on provocative discography, disc height >50% of control, and evidence of single- or two-level degenerative disc disease without evidence of additional changes on magnetic resonance imaging. IDB was performed under fluoroscopy using two radiofrequency probes positioned bilaterally in the intervertebral disc. Thirteen patients completed follow-up questionnaires at 1, 3, and 6 months. Pain disability was evaluated with Oswestry and Short Form (SF)-36 questionnaires. Results., Median visual analog scale pain scores were reduced from 7 (95% confidence interval [CI] 6, 8) to 4 (2, 5) cm at 1 month, and remained at 3 (2, 5) cm at 6 months. The Oswestry improved from 23.3 (SD 7.0) to 16.5 (6.8) points at 1 month and remained similar after 6 months. The SF-36 Physical Functioning scores improved from 51 (18) to 70 (16) points after 6 months, while the SF-36 Bodily Pain score improved from 38 (15) to 54 (23) points. Daily opioid use did not change significantly from baseline: from 40 (95% CI 40, 120) before IDB to 5 (0, 40) mg of morphine sulfate equivalent 6 months after IDB. No procedure-related complications were detected. Conclusions., Patients showed improvements in several pain assessment measures after undergoing IDB for discogenic pain. A randomized controlled study is warranted and needed to address the efficacy of the procedure. [source] Opacity and Lucency Sign of the Seventh Lumbar Vertebra in DogsANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 5 2010S. Kneissl With 2 figures Summary A curvilinear opacity of the seventh vertebral arch and an adjacent focal lucency of the seventh lumbar vertebral body were incidentally noted in routine radiographs. The aim of this study was to analyze this radiographic absorption pattern using a sample of 51 dogs. Images of the bony surface of three macerated lumbosacral junctions were compared to their laterolateral radiographs and computed tomographic (CT) scans. Additional 48 lateral radiographic projections were reviewed for presence or absence of L7 opacity and lucency, length of the L6 and L7 vertebral bodies, vertebral disc disease, osteochondrosis, or spondylosis. Retrieved data were compiled and statistically analyzed. Radiographs and CT scans of the macerated bones revealed that the L7 pedicle had thickened layers of compact bone and the adjacent vertebral notch varying depth and extension. Superimposition of the pedicle on the vertebral body resulted in a curvilinear opacity (L7 opacity), the vertebral notch caused the focal lucency (L7 lucency). These findings were present in 69% of the reviewed radiographs and were found to be significantly associated with L6,L7 length ratios of less than 0.86 (P = 0.003). It is hypothesized that the changes correspond with normal anatomic morphology of the seventh lumbar vertebra plus adaptive bone remodelling. The importance of this study is that it could help avoid misinterpretation of this appearance as a pathologic condition. [source] Proinflammatory cytokine expression profile in degenerated and herniated human intervertebral disc tissuesARTHRITIS & RHEUMATISM, Issue 7 2010Mohammed F. Shamji Objective Prior reports document macrophage and lymphocyte infiltration with proinflammatory cytokine expression in pathologic intervertebral disc (IVD) tissues. Nevertheless, the role of the Th17 lymphocyte lineage in mediating disc disease remains uninvestigated. We undertook this study to evaluate the immunophenotype of pathologic IVD specimens, including interleukin-17 (IL-17) expression, from surgically obtained IVD tissue and from nondegenerated autopsy control tissue. Methods Surgical IVD tissues were procured from patients with degenerative disc disease (n = 25) or herniated IVDs (n = 12); nondegenerated autopsy control tissue was also obtained (n = 8) from the anulus fibrosus and nucleus pulposus regions. Immunohistochemistry was performed for cell surface antigens (CD68 for macrophages, CD4 for lymphocytes) and various cytokines, with differences in cellularity and target immunoreactivity scores analyzed between surgical tissue groups and between autopsy control tissue regions. Results Immunoreactivity for IL-4, IL-6, IL-12, and interferon-, (IFN,) was modest in surgical IVD tissue, although expression was higher in herniated IVD samples and virtually nonexistent in control samples. The Th17 lymphocyte product IL-17 was present in >70% of surgical tissue fields, and among control samples was detected rarely in anulus fibrosus regions and modestly in nucleus pulposus regions. Macrophages were prevalent in surgical tissues, particularly herniated IVD samples, and lymphocytes were expectedly scarce. Control tissue revealed lesser infiltration by macrophages and a near absence of lymphocytes. Conclusion Greater IFN, positivity, macrophage presence, and cellularity in herniated IVDs suggests a pattern of Th1 lymphocyte activation in this pathology. Remarkable pathologic IVD tissue expression of IL-17 is a novel finding that contrasts markedly with low levels of IL-17 in autopsy control tissue. These findings suggest involvement of Th17 lymphocytes in the pathomechanism of disc degeneration. [source] | |||||||||||||